Walgreens

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PS44826 Issued in FL

Legal business name

WALGREENS

Practice address

1903 State Road 60 E
Lake Wales, FL 33853-4329

Phone

(863) 676-9496

NPI assigned

Sep 8, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John Roth

Title

Pharmacy Manager

Phone

(863) 676-9496

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1315440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315440000000",
    "number": "1619258209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1903 STATE ROAD 60 E",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534329",
            "telephone_number": "863-676-9496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 STATE ROAD 60 E",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534329",
            "telephone_number": "863-676-9496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALGREENS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-08",
        "last_updated": "2011-09-08",
        "status": "A",
        "authorized_official_last_name": "ROTH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "863-676-9496"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PS44826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nataliya Voisard
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• Wendy Warman, SLP
• Adeline Brooke Warren
• Amanda Anne Waters, APRN
• We Elderly Care Inc

• Community/Retail Pharmacy in Lake Wales, FL
• Providers in Lake Wales, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.